Macmillan Cancer Support

Macmillan Cancer Support provides specialist information, support, and guidance to people living with cancer in the UK, working closely with health and care professionals and partner organisations. Its mission is to do whatever it takes to help more people with cancer get the best care the UK has to offer, whoever and wherever they are.

The challenge

Macmillan has embarked on an ambitious strategy focused on achieving systemic change for people with cancer, while ensuring people still get the support they need today. The four strategic priorities are:

• Reach everyone and focus on those who need the most support
• Reduce health inequities within cancer treatment and care
• Offer personal support for cancer and other long-term conditions
• Reduce variation in cancer treatment and care

To understand progress across such a wide-ranging portfolio, Macmillan needed a consistent set of overarching evaluation questions that could be applied across programmes, places and delivery models. NPC was commissioned to support Macmillan to develop these evaluation questions, and to help build a framework that could guide meaningful monitoring, evaluation and learning across their strategy.

The approach

We embarked on a collaborative process to build an evaluation framework firmly grounded in Macmillan’s strategy and informed by insights from staff with a range of specialities. Our approach comprised of three core activities:

• Reviewing strategic and evaluation materials, including strategy documents, programmatic theories of change, and prior evaluation approaches.
• Interviewing 26 staff members across the organisation, exploring how they understood systems change, what evaluation looked like in their teams, and where challenges or knowledge gaps existed.
• Facilitating a cross‑organisational workshop, testing and refining the emerging framework, including highlighting the practicalities of using the questions, teasing out different interpretations of concepts, and helping ensure the final framework feels relevant for different teams.

This approach allowed us to develop a structured, scalable set of questions with the final ones organised in three categories:

• System‑focused questions: Helping Macmillan understand the systems it operates in, its role within them, how change happens, and what system‑level impacts are emerging.
• Additional impact questions: Focusing on Macmillan’s direct impact on its priority audiences, particularly those experiencing the greatest health inequities.
• Additional process questions: Enabling learning about delivery approaches, MEL practice, and how lived experience is embedded in design and implementation.

We aimed to create a structure that lets programmes tailor the questions, while keeping learning clear and consistent across the organisation.

The results

NPC’s support provided Macmillan with a practical, strategic framework that strengthens learning across its 2025 strategy. Macmillan is now in the process of tailoring the questions to its different programmes, while maintaining a structure that allows learning to filter up and aggregate across its strategic delivery.